How First Responders and Medical Professionals Keep a Tender Heart

“When we do bighearted things, we get to feel bighearted; and when we do small-hearted things, we get to feel small.” — Ronald Rolheiser, Sacred Fire

I had a brief stint as what I call a “second responder” from 2015 to 2018 as an emergency department nurse. First responders are those who go into homes and dangerous situations and have to sort out a ton of complex and unknown variables with only a bag of basic supplies at their disposal. We “second responders” are the medical personnel with the luxury of receiving those folks after they’ve already been extricated from much of that complexity.

There is much we don’t have in common, so don’t hear me attempting to over-relate to first responders or steal any of the valor that rightfully comes with that role. What we do have in common, however, is daily experience with the unfairness and brutality of life. With that experience comes an inner struggle that few people navigate with great success: the struggle to remain hopeful, compassionate, and tenderhearted despite coming face-to-face with so much perplexing evil and despair.

The Consequences of Too Much Self-Protection

If you’ve hung out in any of these circles, you’ve seen the folks who succumb to the temptation we all experience: becoming calloused and hard about tragedies. To some degree, that’s a job requirement. You can’t operate under pressure if you are breaking down with emotion in the heat of the moment. But for some, it goes too far. They got into the job because they cared about justice and helping their community, but now they just feel angry, numb, or detached. They’ve helped so many people who showed no gratitude or who have quite literally tried to physically harm them for helping. They’ve seen so many situations where the innocent die and the perpetrator lives. The unfairness of it all adds up over time, and the attitudes of your calloused coworkers start to rub off on you.

I think everyone has to hit this part in their journey at some point. It’s part of the inevitable soreness of building the emotional muscle of shelving your feelings to deal with the unimaginable scenes unfolding in front of you. The important question is whether or not you correct your course and figure out how to shut it down in the moment—but not stay shut down all the time out of self-protection.

The issue with being too self-protective is that it’s difficult, if not impossible, to selectively turn that on and off. Inevitably, that self-protection dulls more parts of your life than just the hard times. Not only does it steal your joy, but it steals what you have to offer the world, which is the very reason you were interested in this profession in the first place.

What We Must Do to Keep Hope Alive

So, what are we to do to keep the darkness from taking over our hearts and attitudes? A book from the Old Testament, Ecclesiastes, offers some guidance. After thoroughly tearing down our illusions that life is fair and that optimization can deliver satisfaction, the author sprinkles in some hope and guidance:

“Behold, what I have seen to be good and fitting is to eat and drink and find enjoyment in all the toil with which one toils under the sun the few days of his life that God has given him, for this is his lot. 

Everyone also to whom God has given wealth and possessions and power to enjoy them, and to accept his lot and rejoice in his toil—this is the gift of God. 

For he will not much remember the days of his life because God keeps him occupied with joy in his heart.” — Ecclesiastes 5:18-20 ESV

Bobby Jamieson, in his book Everything is Never Enough, makes the case that the word "lot" can be translated as “small good thing.”

Those small good things you get to be a part of as a result of your work (toil) are a gift you must relish. If we miss the small good things in our lives and in our work, we will miss all of the goodness and beauty that life has to offer. You might not identify as someone to whom God has given wealth, possessions, and power, but you have far more than you think.

Tenderhearted Heros

How do we put this into practice so that our adaptive self-protection during tragic and difficult moments doesn’t turn into maladaptive self-protection that steals our joy in the good things? You have to be willing to feel pain in order to feel joy, see life as a gift, and act in bighearted ways.

If you have worked on the medical side of the first or second responder world in the past 20 years in Central Mississippi, then you know there is a certain ER doctor at UMMC who is famously hopeful, kind, and fun to work with. I won’t name them, but if you know, you know.

Here’s what I noticed about them and all the others who remained truly kind and compassionate despite the horrific things they see: they celebrate. When we would save someone’s life, there were fist pumps, side hugs, and a couple of high fives. This is how you battle the nihilism that tells you all is meaningless.

If you’ve blocked off all feeling in order to protect yourself, then you aren’t going to feel the joy of the power that you had to make a positive change in that situation. You protected yourself from many painful emotions, yes, but you also protected yourself from being able to rejoice. Chances are that not rejoicing in the cool things that you get to do is bleeding over into other parts of your world as well. What I am talking about attempting here is no easy task, so don’t hear me being accusatory. I only lasted a few years as even a second responder, and I have a ton of respect for those who churn out decades and whole careers.

What you must recover is a touch of childlike naïveté. You get to put out fires, create order where there is chaos, protect the innocent, comfort the dying, and allow people to enjoy their lives. That’s hero stuff. But the tragedy comes when you can’t enjoy being a hero, rejoice in your toil, and accept your lot.

A Unique Perspective and Unique Opportunity

You are not in control of your life to the degree that you wish. Many people don’t get to see this so clearly. First responders and folks in the medical field have a unique opportunity to view life as a gift. When you’ve seen life cut short and injustice win too often, healthy perspective is difficult to achieve. On one hand, you can start to feel like everything is meaningless, but there is another option to fight for mentally and emotionally. The other option is to take nothing for granted and to be fully present and celebratory when light does prevail over darkness—to accept your “lot”—the small good things that God grants you both in your job and outside of it. Those who are acquainted with grief, if they’ll work to achieve this perspective, often do this better than most people.

So, if you protect the public, enjoy the power God has given you and appreciate the small good things you are a part of.

If you put stents in arteries, rejoice when it goes well and be grateful when good prevails.

If you comfort the sick and the dying, enjoy the power you have to create a meaningful experience for the patient and their family.

If you put out fires and pull people out of wrecked cars, reconnect with how cool it is that you get to be a hero.

Work hard to be bighearted, childlike, and a touch naive. Celebrate, high-five, nerd out on what you do, and get excited when things go right. You can do this and still be great at your job. Your heart will thank you, your life will be more satisfying, and the people you serve will notice.